Improving Medical Student Access to Nutrition During the Core Surgery Clerkship.

The rigorous demands of medical education create circumstances that can make it challenging to maintain a healthy diet. Evaluations from students at an urban medical school in the northeast U.S.

How do soundboard-trained dogs respond to human button presses? An investigation into word comprehension.

Past research on interspecies communication has shown that animals can be trained to use Augmentative Interspecies Communication (AIC) devices, such as soundboards, to make simple requests of their caretakers. The recent uptake in AIC devices by hundreds of pet owners around the world offers a novel opportunity to investigate whether AIC is possible with owner-trained family dogs. To answer this question, we carried out two studies to test pet dogs' ability to recognise and respond appropriately to food-related, play-related, and outside-related words on their soundboards.

Evolving Medical Student Experiences in the Surgery Clerkship: A New Generation.

Background: The surgery clerkship has a powerful impact on medical students' attitudes toward surgery. The primary aim of this study was to identify factors that influence current medical student experiences during the surgery clerkship and discern if they have shifted following the COVID pandemic and with a new generation of "Zillennial" students.

Materials And Methods: We conducted a qualitative content analysis of medical student surgery clerkship evaluations from 2018 to 2022 at three clinical training sites of our medical school (n = 596).

Angiography with cone-beam CT versus contrast-enhanced MRI for living donor transplant imaging: Is MRI enough?

The purpose of this study is to compare the subjective and objective quality and confidence between conventional angiography with cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) for the preoperative evaluation of potential donors for living donor liver transplant. Seventeen patients undergoing preoperative donor evaluation for living donor liver transplantation that underwent angiography with CBCT and contrast-enhanced MRI for evaluation of hepatic vascular anatomy were included in the study. Four attending radiologists interpreted anonymized, randomized angiography with CBCT images and MRIs, rating the diagnostic quality and confidence of their interpretation (on a 3-point scale) for each element, as well as clinically relevant measurements.

Use of Augmentative Interspecies Communication devices in animal language studies: A review.

Countless discussions have been generated by the animal language studies, specifically those utilizing mechanical interfaces, termed here Augmentative Interspecies Communication (AIC) devices (e.g., lexigrams; magnetic chips; keyboards).

Surgical Adaptation of the Situation Awareness Rating Technique (S-SART): Assessing Situational Awareness Among Medical Students.

Objective: Situational awareness (SA) impacts team dynamics and patient care. However, few formal curricula and tools exist to teach and assess longitudinal SA in surgical environments. We sought to evaluate medical students' SA in the operating room (OR) during surgical clerkships over time.

Gastrointestinal distress, State and Trait anxiety, and dietary intake among college students during the COVID-19 pandemic.

Objective: This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic.

Participants: A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021.

Methods: An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used.

Rabies in a Dog Imported from Azerbaijan - Pennsylvania, 2021.

On June 16, 2021, rabies virus infection was confirmed in a dog included in a shipment of rescue animals imported into the United States from Azerbaijan. A multistate investigation was conducted to prevent secondary rabies cases, avoid reintroduction of a dog-maintained rabies virus variant (DMRVV), identify persons who might have been exposed and would be recommended to receive rabies postexposure prophylaxis, and investigate the cause of importation control failures. Results of a prospective serologic monitoring (PSM) protocol suggested that seven of 32 (22%) animals from the same shipment as the dog with confirmed rabies virus infection and who had available titer results after rabies vaccine booster had not been adequately vaccinated against rabies before importation.

A multisite study of medical student perspectives on the core surgical clerkship.

Background: The surgical clerkship is the primary surgical learning experience for medical students. This study aims to understand student perspectives on the surgery clerkship both before and after the core surgical rotation.

Methods: Medical students at 4 academic hospitals completed pre and postclerkship surveys that included open-ended questions regarding (1) student learning goals and concerns and (2) how surgical clerkship learning could be enhanced.

Liver Disease is Associated with Increased Mortality and Major Morbidity After Infra-Inguinal Bypass but not After Endovascular Intervention.

Objective: Liver disease increases mortality after abdominal surgery, including endovascular aortic aneurysm repair. However, its effect on mortality and morbidity after endovascular and open management of peripheral vascular disease has not been widely evaluated.

Methods: The National Surgical Quality Improvement Program was used to evaluate patients undergoing infra-inguinal bypass and endovascular intervention (2005 - 2016).

Identification of Specific Educational Targets to Improve the Student Surgical Clerkship Experience.

Background: This study describes the relationship between medical student perception of surgery, frequency of positive surgery clerkship activities, and overall surgical clerkship experience.

Methods: Medical students at four academic hospitals completed pre- and post-clerkship surveys assessing 1) surgery clerkship activities/experiences and 2) perceptions of surgery during the 2017-2018 academic year.

Results: Ninety-one percent of students completed both a pre- and post-clerkship survey (n = 162 of 179).

Aspartate transaminase to platelet ratio index and Model for End-Stage Liver Disease scores are associated with morbidity and mortality after endovascular aneurysm repair among patients with liver dysfunction.

Background: Liver cirrhosis dramatically increases morbidity and mortality after open surgical procedures and is often a contraindication to open repair of abdominal aortic aneurysms. However, limited data have evaluated the effect of liver disease on outcomes after endovascular repair of aortic aneurysms.

Methods: The National Surgical Quality Improvement Program was used to evaluate all nonemergent endovascular aneurysm repairs (EVARs) from 2005 to 2016.

The Abdominal Transplant Surgery Workforce: Current state and future trends.

Transplant surgical workforce concerns have arisen in the last 5 years as reflected in challenges securing job opportunities for new fellows. The present survey was designed by the ASTS Membership and Workforce Committee to describe the current practice characteristics of transplant centers in order to estimate changes in the workforce. The survey questionnaire requested information about the transplant programs, the transplant surgeons involved in the program, and the estimated changes in the staffing of the program over the next 3 years.

Primary Stent Placement for Hepatic Artery Stenosis After Liver Transplantation: Improving Primary Patency and Reintervention Rates.

Recent studies have reported high rates of reintervention after primary stenting for hepatic artery stenosis (HAS) due to the loss of primary patency. The aims of this study were to evaluate the outcomes of primary stenting after HAS in a large cohort with longterm follow-up. After institutional review board approval, all patients undergoing liver transplantation between 2003 and 2017 at a single institution were evaluated for occurrence of hepatic artery complications.

Mistreatment and the Learning Environment: A Mixed Methods Approach to Assess Knowledge and Raise Awareness Amongst Residents.

Objective: Trainee mistreatment, either intentional or unintentional, negatively affects the learning environment. This study was undertaken to evaluate the impact of an educational intervention about mistreatment and the learning environment on general surgery residents.

Design: Video-based modules were developed and added to the residency curriculum.

The Living Donor Lost Wages Trial: Study Rationale and Protocol.

Purpose Of Review: This paper describes the background, rationale, and design of an NIH-funded, single-center study to test the impact of offering reimbursement for donor lost wages incurred during the post-nephrectomy recovery period on the live donor kidney transplant (LDKT) rate in newly evaluated kidney transplant candidates, to examine whether offering reimbursement for donor lost wages reduces racial disparity in LDKT rates, and to determine whether higher reimbursement amounts lead to higher LDKT rates.

Recent Findings: LDKT is the optimal treatment for renal failure. However, living kidney donation has declined in the past decade, particularly among men, younger adults, blacks, and low-income adults.

INITIAL VALIDATION OF THE ASSESSMENT OF PARENTING TOOL: A TASK- AND DOMAIN-LEVEL MEASURE OF PARENTING SELF-EFFICACY FOR PARENTS OF INFANTS FROM BIRTH TO 24 MONTHS OF AGE.

Parenting self-efficacy (PSE) includes parents' self-perceptions regarding their capabilities in performing the numerous and changing tasks associated with parenting a specific child (i.e., domain-specific PSE) as well as their self-perceptions in the parenting role overall (i.

Educational Intervention Impact on Osteoporosis Knowledge, Health Beliefs, Self-Efficacy, Dietary Calcium, and Vitamin D Intakes in Young Adults.

Background: Successful prevention of osteoporosis begins early in life. Adequate intake of calcium and vitamin D plays a role in this prevention along with knowledge, health beliefs, and self-efficacy related to preventive dietary behaviors.

Purpose: The purpose of this theory-based study was to examine young adults' knowledge of osteoporosis, health beliefs, self-efficacy, dietary calcium, and vitamin D intakes as measures of preventive behaviors.

Stereotactic Body Radiotherapy (SBRT) for Intrahepatic and Hilar Cholangiocarcinoma.

Background: Unresectable intrahepatic and hilar cholangiocarcinomas carry a dismal prognosis. Systemic chemotherapy and conventional external beam radiation and brachytherapy have been used with limited success. We explored the use of stereotactic body radiotherapy (SBRT) for these patients.

Therapeutic Potential of Adjuvant Stereotactic Body Radiotherapy for Gallbladder Cancer.

Surgical treatment remains the only curative treatment for gallbladder cancer. However, even after liver resection, locoregional failure seems to be a significant problem. While there is no Level I evidence, multiple studies have shown benefit for adjuvant radiation in high-risk patients.

Management of Hepatocellular Carcinoma in Cirrhotic Patients with Portal Hypertension: Relevance of Hagen-Poiseuille's Law.

Background: Hepatic decompensation in cirrhosis heralds an accelerated course with poor survival. An increase in hepatic venous pressure gradient (HVPG), rather than surrogate tests of liver function, appears to be the sole predictor of decompensation after surgical resection. We propose that hepatic sinusoidal walls become less elastic as cirrhosis progresses.

Patient-Reported Outcomes Following Living Kidney Donation: A Single Center Experience.

This article describes the development and implementation of an initiative at one transplant center to annually assess psychosocial outcomes of living kidney donors. The current analysis focuses on a cohort of adults (n = 208) who donated a kidney at BIDMC between September 2005 and August 2012, in which two post-donation annual assessments could be examined. One and two year post-donation surveys were returned by 59 % (n = 123) and 47 % (n = 98) of LKDs, respectively.

[18F]fludeoxyglucose positron emission tomography and computed tomography as a prognostic tool before liver transplantation, resection, and loco-ablative therapies for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third most common cause of cancer-related death worldwide. Orthotopic liver transplantation (OLT) and resection are curative treatment options for well-selected patients with HCC, whereas loco-ablative therapy has been shown to prolong survival. Organ and treatment allocations for these patients are currently based on the number and size of tumors, as defined by the Milan criteria, and on functional capacity, and they are incorporated into the Barcelona Clinic Liver Cancer staging system and treatment strategy.

Hagen-Poiseuille's law: The link between cirrhosis, liver stiffness, portal hypertension and hepatic decompensation.

The onset of hepatic decompensation in cirrhosis heralds an accelerated downhill course with poor outcome. The sole predictor of this decompensation in cirrhosis is increased hepatic vein to portal vein gradient hepatic venous pressure gradient (HVPG). Surrogate markers of liver function or hepatic reserve appear to be less relevant.